Transurethral resection (TUR) is common practice in urologic surgery and is employed in the treatment of conditions affecting the lower urinary channel, including the urethra, prostate, and bladder. More than 150,000 TUR procedures are performed in the U.S. each year to cut out bladder tumors or reduce enlarged prostates. The primary tool for conducting a TUR is a transurethral resectoscope, a surgical instrument that employs an electrode to cut and cauterize tissue. It is a type of endoscope, an instrument that combines a camera and instrumentation that allows surgeons to view and perform surgery through a small incision or orifice.
The resectoscope is a surgical tool designed to be inserted into the urethra to treat conditions related to the prostate or bladder in a minimally invasive fashion. Traditionally, a resectoscope consists of an assembly of components that when put together, make up a full resectoscope. These parts include a working element, a long lens, electrocautery electrode (loop), inner sheath, and an outer sheath. Once fully assembled the user, i.e. the surgeon, inserts the resectoscope into a patient's body to perform the surgery.
The resectoscope's cutting element has a fixed orientation with respect to the handle, meaning that the surgeon has to rotate the handle of the tool in order to reach each cutting area. On many operations, the doctor needs to operate on all walls of the prostate or bladder, which requires a 360-degree rotation of the resectoscope handle. Due to the limited rotation of the surgeon's hand, they are forced to switch to their non-dominant hand or hold the handle upside down. Since the resectoscope is not designed for this, the surgeon's grip on the tool in these positions is less comfortable and results in lower precision. Outside of the ergonomic 90-degrees of rotation achievable by most doctors, they have to operate in an awkward, inefficient, and imprecise position. The result is a less effective, more dangerous, and longer surgery.
The conventional resectoscope is designed as a reusable device, which is normally sterilized after each use, and then repurposed for another patient. This re-sterilization and repurposing can be costly and time consuming, and holds the risk of cross-contaminating resistant organisms from one patient to another. This is especially pertinent in an age where resistant organisms are currently on the rise.
Additionally, the way a conventional resectoscope is designed restricts a surgeon during certain positions. Often surgeons are required to resect in a 360-degree field. However, due to the natural movement of a human wrist, a surgeon is often limited when these positions require him or her to rotate their hand fully counterclockwise.
In response to this uncomfortable hand movement, surgeons often compensate by holding the handle in the opposite hand, or upside down, which is not the intended use of the resectoscope. This unintended hand positioning on a resectoscope can make a surgeon's hand movements unsteady and imprecise, which can put a patient at risk. Additionally, the surgeon's hand is restricted by the presence of irrigation, power for a light source, and camera cables or cords which often get in the way when a surgeon attempts to rotate the resectoscope in 360-degree space.
Considering the above, there is thus a need for an improved resectoscope whose features address the issues of cost effectiveness, patient safety, and surgeon comfort. In addition, there is a need for a resectoscope that is designed to be disposable.